0.05).The usage rate of antimicrobial agents in inpatients and outpatients was 74.65% and 45.52% respectively,with a significant difference(P

OBJECTIVE To evaluate the bioethical principles which should be followed in the epidemiological study of AIDS.METHODS Practicality of bioethical principles in epidemiological study of AIDS was evaluated by theoretical analysis method.RESULTS The important principles in the epidemiological study of AIDS are respect,beneficence/nonmaleficence and justice principles.CONCLUSIONS Following bioehical principle is the basis of epidemiological study of AIDS.

Analysised the transmission routes of AIDS in hospital,preventive strategies and existing ethic problems.Putting forward the importance of respecting the proper right of AIDS patients and health care workers in the prevention of nosocomial-transmitted HIV.On the basis of scientific study,strengthening the propagating of the knowledge of AIDS in the whole society,respecting the right and statue of AIDS prevention and timely treatment among both patients and health care workers.Respecting their medical treatment right and secrets,detecting HIV of patients on the informed consent.Respecting health care workers' right,providing profession guide and preventive strategies for prevention and control of nosocomial-transmitted AIDS.

Objective To study the levels of interleukin-6(IL-6)and tumor necrosis factor-alfa(TNF- α)in serum and peritoneal fluid of women with endometriosis,to explore their roles in pathogenesis of endometriosis. Methods IL-6 and TNF-α levels in peritoneal fluid and serum of 60 patients with endometriosis(34 cases in Ⅰ ～ Ⅱ stage,26 cases in Ⅲ ～ Ⅳ stage)and 30 control cases(not EMS patients)were detected by enzyme linked immunosorbent assay(ELISA). Results Peritoneal fluid and serum levels of IL-6 and TNF-α in EMS group were significantly higher than that in control group(P＜0.01),and peritoneal fluid and serum levels of IL-6 and TNF-α in Ⅲ ～Ⅳ stage was siguificantly higher than that in Ⅰ ～ Ⅱ stage(P＜0.01). Conclusion IL-6 and TNF-α in peritoneal fluid and serum played an important role in pathogenesis of endometriosis.

Objective To investigate the nationwide prevalence of healthcare-associated infection (HAI),and es-tablish the related indexes of HAI.Methods A cross-sectional survey was conducted through combination of bed-side investigation and medical record reviewing,the prevalence of HAI in hospitals of National HAI Surveillance System and other hospitals voluntarily participated in the survey were investigated according to unified survey pro-gram.Results A total of 1 008 584 patients in 1 766 hospitals participated in the survey,26 972 cases of HAI occurred, prevalence rate of HAI was 2.67%,antimicrobial usage rate was 35.01%.Difference in prevalence rates of HAI and anti-microbial usage rates among hospitals with different number of beds were both significant (χ2 =1 599.21,3 458.40,re-spectively,both P <0.01).The main infection sites were lower respiratory tract (47.53%),urinary tract (11.56%)and surgical site(10.41%).A total of 13 784 pathogenic strains were isolated,the top five pathogens were Pseudomonas aeruginosa ,Escherichia coli ,Klebsiella pneumoniae ,Acinetobacter baumannii ,and Staphylococcus aureus .Prevalence rate of HAI and prophylactic antimicrobial usage rate in patients receiving operation of class Ⅰincision were 1.01% and 27.99% respectively,difference in prophylactic antimicrobial usage rates in patients receiving operation of classⅠincision at hospitals with different number of beds were significant (χ2 =400.34,P <0.01 );among patients receiving antimicrobial prophylaxis,percentage of specimens sending for bacterial detection was 45.89%,difference in bacterial detection rates in hospitals with different number of beds were significant (χ2 =9 189.90,P <0.01).Hospital with more than 900 beds had the highest prevalence rate of HAI(3.36%),lowest usage rate of antimicrobial agents(32.35%),and highest bacterial de-tection rate(56.03%).Conclusion Multiple indexes of this cross-sectional survey revealed that HAI management in China has achieved remarkable results;meanwhile,calculation of the percentile distribution of each index is convenient for self-evaluation for HAI-related work in each hospital.

Objective To observe the therapeutic effect of interferon-? on adult patients with HBV associated glomerulonephritis.Methods Nine patients with HBV associated glomerulonephritis diagnosed in Shanghai Ruijin Hospital from September 1996 to March 2003 were treated with interferon-? at a dose of 3 million units every other day and the total period was 6 to 9 months.The proteinuria,serum HBV marks and bDNA were measured before and after therapy.Results At the end of the therapy urinary protein excretion significantly reduced(P

Objective To analyse the clinicopathological changes of Alport syndrome (AS) and to detect the deposition of type Ⅳ collagen within basement membrane of Alport patients. Methods Fourteen patients with AS (12 families) hospitalized from 1990. 1 to 1996. 6 were investigated. Eleven were male and 3 female (mean age 29. 4 years). Results Microscopic hematuria was found in 13, with recurrent gross hematuria in 7. All had proteinuria. Three patients presented nephrotic syndrome. Progressive renal failure occured in 10 of 11 male(11 - 39 years) and 1 female (40 years). Six patients were treated with hemodialysis, two of them with transplantation. Sensorineural deafness was observed in 9 patients particularly high frequency sound. Anterior lenticonus were presented in 2. It showed heterogeneitic, 50% transmitted as X-linked dominant(XD) trait. In 7 renal biopsies, the findings by light microscopy mostly revealed focal and segmental sclerosis glomerulonephritis (4/7). The results of immunofluorescenc e (IF) were ne gatt ye in 4. Ultrastructural studies showed variable thickening, thinning of glomerular basement membrane (GBM) in 7 specimens with lamellation and basket-weaving of GBM in 1. Using the iIF technique, the ?3, 4, 5 (Ⅳ) chains were absent within both GBM and EBM of 4 male XD-AS patients. Conclusions AS is not a rare hereditary disease characterized by hematuria, proteinuria and progressive renal failure with sensorineural deafness and ocular lesions. Type Ⅳ collagen within Alpori patients' basement membrane is abnormal and iIF study of type Ⅳ collagen chains distribution is useful to confirm the diagnosis of AS.

Objective\ To investigate the effect and safety of LMWH on treatment of nephrotic syndrome(NS).Methods\ We randomized 43 patients with primary NS into 2 groups.Steroid and cyclophosphamide were given in control group.LMWH with the dosage of 3200～5000IU twice per day was added in the treated group.Results\ After 4 to 6 weeks of treatment,a significant increase in AT-Ⅲ,anti-Xa activity and serum albumin and decrease in fibrinogen and proteinuria were observed in LMWH.Conclusion\ LMWH should be recommended as a useful treatment of NS.

Objective To evaluate the renal involvement and therapeutic effect on ANCA-associated vasculitis(ASV) . Methods Fifty-six cases were diagnosed as ASV from Oct 1997 to Mar 2001. Among them, 21 cases received renal biopsies. According to disease activity and severity, Use following treatment protocols were choosed: (1) double pulse therapy; (2) single pulse therapy; (3) oral prednisone and/or low dose of CTX; (4) blood purification technique and/or immunosuppressive therapy. Remission rate was also analyzed. Results 96. 4% of case suffered with renal involvement. 91. 1% with acute renal failure, 96.4% with severe renal failure, 98. 2% with multiple organs involvement. The mortality was 19. 6% and the remission rate 67. 9%. 12. 5% of cases lost follow-up. ConclusionsRenal involvement is common and serious in ASV patients. Individualized and early therapy, as well as valuable urgent renal biopsy are necessary. To those who have entered ESRD, immunosuppressive agents could be used to decrease the extra-renal complication.

Objectives To investigate the incidence of deep vein thrombosis (DVT) of lower limbs and pulmonary embolism (PE) caused by hypercoagubility in patients with nephrotic syndrome and to estimate the indication and clinical effect of anticoagulation therapy. Methods 54 patients with nephrotis syndrome(thirty-one males and twenty-three females with mean age: 44 13?15 88, 24 hours proteinuria:8 43?5 64g, albuminemia: 20 48?5 41g/L) were enrolled in this study.DVT of lower limbs and PE were confirmed by radionuclide imaging (RNV) with 99mTc-MAA and the clinical effect of subcutaneous injection of low molecular weight heparin (LMWH) and oral antiplatelet coagulation therapy were evaluated as well. Results 41 out of 54 cases (76%) had DVT of lower limbs, 14 8% of which had clinical manifestations. 32 out of 54 cases (59 25%) had PE, 7 4% of which had symptoms. 70 7% of PE were caused by DVT of lower limbs. No patient died of PE after the LMWH treatment.Conclusions DVT is one of the most important complications of NS. RNV can be used to make early diagnosis of DVT of lower limbs and PE. Early anticoagulation therapy might ameliorate the prognosis of NS and lower the mortality of PE.